World Ophthalmology Congress 2010 Review

New era in the treatment of retinal vascular disease

"This will revolutionize our therapeutic approaches to the challenge of preventing avoidable blindness," declared Dr Lang. "The two most common retinal vascular diseases are diabetic retinopathy and retinal vein occlusions. Diabetic retinopathy is the leading cause of blindness in the working-age population. An estimated eight million people in Germany and 24 million in the United States suffer from diabetes mellitus. After individual patients have suffered from this problem for 15 years nearly 90 per cent of them with Type 1 and 84 per cent of them with Type 2 develop diabetic retinopathy. The relative risk of people in Germany going blind amounts to 5.2 per cent of the population.

"We have now experienced a major breakthrough in treatment of macular oedema related to diabetic retinopathy and vein occlusions. The RESOLVE and RESTORE studies from the Novartis company and the study of the DRCnet Group on treatment of DME with ranibizumab and they showed that ranibizumab is significantly more effective than the care offered by laser treatment. Similar to the breakthrough in AMD several years ago when we were able to improve vision in patients with wet AMD we now have reached the point that if we treat diabetic patients with ranibizumab they experience a significant improvement in visual acuity. In former days we were thinking about prevention of visual loss but now a new era starts and we can bring back vision to diabetic patients which is so important because diabetes is the most common cause of blindness in working-age people so the patients who could no longer work or drive can now, with the new VEGF treatment, work again and enjoy life.

"The second most common disease of the retina vessels is vein occlusion. It is and age-related disease. Beyond the age of 80, 4.6 per cent of the population is affected. The CRUISE and BRVO studies tested ranibizumab on vein occlusion with patients being given injections of the antibody or placebo over a six month period. In the BRVO study there was a noteable improvement in visual acuity. After six months, those patients who received a dosage of 0.5 mg of ranibizumab were able to read 18.3 letters or 3.7 lines more on the vision chart than the average. Those patients who received placebo injections gained seven letters or 1.4 lines on average.

"We have waited for forty years for this kind of breakthrough. We have worked in this area for a long time and tried several different compounds but have always been disappointed after around 6-8 years of work when we found they were not effective. This is the beginning of a new era."